Provider Demographics
NPI:1760486229
Name:IRWIN, BRANDITH G (MD)
Entity Type:Individual
Prefix:DR
First Name:BRANDITH
Middle Name:G
Last Name:IRWIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1101 MADISON ST
Mailing Address - Street 2:STE 1490
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3598
Mailing Address - Country:US
Mailing Address - Phone:206-215-6600
Mailing Address - Fax:206-215-6650
Practice Address - Street 1:600 BROADWAY STE 112
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5381
Practice Address - Country:US
Practice Address - Phone:206-939-6633
Practice Address - Fax:206-939-6633
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00023014207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB22637Medicare ID - Type Unspecified
WAE72299Medicare UPIN